Provider Demographics
NPI:1376023135
Name:LINTAO, MIANNA (FNP-C)
Entity Type:Individual
Prefix:
First Name:MIANNA
Middle Name:
Last Name:LINTAO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 BLOSSOM ST STE C
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4194
Mailing Address - Country:US
Mailing Address - Phone:832-376-8500
Mailing Address - Fax:832-376-8505
Practice Address - Street 1:201 BLOSSOM ST STE C
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4194
Practice Address - Country:US
Practice Address - Phone:832-376-8500
Practice Address - Fax:832-376-8505
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF03180060363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care